Medical Screening and Diagnostic Imaging for the Direct Access Physical Therapist

Course Outline:  This course will highlight the various responsibilities physical therapists have when providing care as the patient's first contact into the healthcare system.  Emphasis will be placed on screening for conditions that may fall outside our scope of practice, determining when and if diagnostic imaging studies are necessary, how to decide what imaging study would be most beneficial, and how to appropriately categorize patients into relevant referral types.  The course will include several case studies interspersed throughout the training along with ample time for discussion.  The course will conclude with a post-test to assess therapist competency.

Objectives:
1.  Describe the responsibilities physical therapists have in functioning as first-contact providers.
2.  Implement medical screening procedures to appropriately identify conditions that may fall outside the physical therapists' scope of practice.
3.  Implement evidence-based guidelines related to ordering of appropriate diagnostic imaging studies.
4.  Demonstrate appropriate use of the American College of Radiology Appropriateness Criteria.
5.  Differentiate between conditions that require either an emergent, urgent, or general referral.

Course Schedule:
Day 1:  Medical Screening
  8:00-  8:30  Registration/Check-in
  8:30-  9:00  Introduction/Course Overview
  9:00-10:00  Topics:
* Inherent bias in decision-making
* To screen or not to screen?
* When red flags aren't so red
* What matters most?
10:00-12:00 Specific diagnoses covered:
* CA (spine mets)
* Infection (spine)
* Spine Fractures
* Cauda Equina
12:00- 1:00 LUNCH
  1:00-  3:00 Specific diagnoses covered:
* Myelopathy
* Ankylosing Spondylitis
* DVT/PE
* Visceral Referral
* HTN
  3:00-  4:00 Lab
  4:00-  4:30 Q & A
Day 2:  Diagnostic Imaging
  8:30-  9:00Review from Day 1
  9:00-10:00 Topics:
* The problems with imaging
* The value of imaging
10:00-12:00 Topics
* Plain Film X-rays
* MRI
* CT Scans
* Bone Scans
12:00- 1:00 p.m. LUNCH
  1:00- 2:00 p.m.  Case Studies/Group Participation
  2:00- 4:00 p.m.  When to order and what to order
  4:00- 4:30 p.m.  Q and A

Speaker:
Aaron Keil, PT, DPT, OCS, is Assistant Head of Clinical Affairs/Clinical Associate Professor at the University of Illinois-Chicago.  He is also the Director of Faculty Practice and Director of Orthopedic Residency at UIC.  In addition to membership in the APTA, Dr. Keil is a member of the Orthopedic Section, Foot and Ankle Special Interest Group, and the Imaging Special Interest Group.